Evaluating Transcriptomic Biomarkers for rHuEPO Detection: Assessing the Impact of Exercise and Altitude Exposure

Obratov, D ORCID: 0009-0007-9495-0136, Sutehall, S ORCID: 0000-0003-3363-7975, Liu, L ORCID: 0000-0001-6501-863X, Zhongying, Z ORCID: 0000-0003-2743-9008 and Pitsiladis, Y ORCID: 0000-0001-6210-2449 (2026) Evaluating Transcriptomic Biomarkers for rHuEPO Detection: Assessing the Impact of Exercise and Altitude Exposure. Drug Testing and Analysis, 18 (4). pp. 581-602. ISSN 1942-7603

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Abstract

Recombinant human erythropoietin (rHuEPO) is often misused in endurance sports due to its potent erythropoietic effects. While transcriptomic biomarkers hold promise for detecting rHuEPO use beyond conventional testing windows, many proposed gene markers may also respond to physiological stimuli such as exercise or altitude. This study compared 153 previously reported rHuEPO-responsive genes in whole blood with transcripts identified during exercise (GEPREP database) and high-altitude exposure (four independent studies). For the exercise dataset, gene-level statistical outputs were obtained directly from the GEPREP database, while biological relevance was calculated using Cohen's d. Analyses of altitude and rHuEPO datasets followed the original statistical procedures described in each study. Among the 153 rHuEPO-responsive genes, 94 overlapped with altitude and 34 with exercise. However, 50 genes remained unaffected by either exercise or altitude stimuli. Enriched in post-translational regulation and intracellular transport pathways, these genes represent promising candidate transcriptomic markers of rHuEPO administration. This work provides a refined gene panel that reduces the likelihood of false positives and requires further experimental validation before integration into RNA-based detection tests.

Item Type:	Article
Uncontrolled Keywords:	altitude; antidoping; erythropoietin; exercise; transcriptomics; Humans; Erythropoietin; Recombinant Proteins; Exercise; Substance Abuse Detection; Altitude; Doping in Sports; Male; Transcriptome; Biomarkers; altitude; antidoping; erythropoietin; exercise; transcriptomics; Humans; Erythropoietin; Altitude; Exercise; Transcriptome; Doping in Sports; Biomarkers; Recombinant Proteins; Substance Abuse Detection; Male; 3214 Pharmacology and Pharmaceutical Sciences; 32 Biomedical and Clinical Sciences; Women's Health; Prevention; Genetics; Physical Activity; Biotechnology; Human Genome; Humans; Erythropoietin; Altitude; Exercise; Transcriptome; Doping in Sports; Biomarkers; Recombinant Proteins; Substance Abuse Detection; Male; 0301 Analytical Chemistry; 0601 Biochemistry and Cell Biology; 1115 Pharmacology and Pharmaceutical Sciences; Analytical Chemistry; 3214 Pharmacology and pharmaceutical sciences
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Wiley
Date of acceptance:	2 February 2026
Date of first compliant Open Access:	27 May 2026
Date Deposited:	27 May 2026 09:33
Last Modified:	27 May 2026 09:33
DOI or ID number:	10.1002/dta.70040
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28665

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